Diaper dermatitis Flashcards
What is the pathophysiology of diaper dermatitis?
Combination of things present in the diaper environment that reflect progressive barrier compromise
How does irritant diaper dermatitis present?
mild erythema, convex surfaces affected while skin folds are spared.
How does allergic diaper dermatitis present?
Grouped or linear vesicles and blisters. Marked edema in severe cases. Affected location is limited to area in contact with the allergen.
How does candidal dermatitis present?
Beefy red plaques with satellite pustules and early maceration of skin, usually painful especially when urinating/defecating and changing diapers
Skin folds almost always affected.
What are red flags of diaper dermaitis?
- Pus, vesicles or ulceration
- Frequent
- Moderate/severe presentation
- Rash outside the diaper area
- secondary infection or UTI
- behavioural changes
- signs of abuse or neglect
- immunocompromised
- fails to improve despite 7 days of treatment or fails to resolve after 14 days of treatment
What are the ABCDEs of non-pharm strategies for diaper dermatitis?
A- air, absorptives B- barriers C- cleansing, compressing D- diapers (change q3-4h) E- education
When do we use hydrocortisone to treat DD?
If it’s predominantly inflammatory
When are barrier-only products used?
To prevent DD only
What are examples of barrier-only products? What is their dosage?
Ceramide based
Petrolatum
Silicone-based
Apply generously PRN
When do we use barrier-absorptive products?
To treat and prevent DD
What is an example of a barrier-absorptive product?
Zinc oxide; has astringent and antiseptic properties
What do we use to treat candidal diaper dermatitis?
Clotrimazole 1%, miconazole 2% or nystatin
topical antifungals
If an antifungal, corticosteroid and barrier product is required, which order should they be applied in?
Antifungal –>hydrocortisone –> barrier product
Application of each product should be separated by a few minutes
